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Complete Inversion of the Uterus During Labor
Society NEW
YORK MEETING
Transactions
OBSTETRICAL OF
MARCH
SOCIETY 11,
1930
D IR. J. H. TELFAIR presented a report on Complete Inversion of the Uterus During Labor, and said that this was the second case where he reinverted the uterus by simply pushing it up into the pelvis, and in each case it was rather easy to replace the uterus in normal position through the noncontracted cervical muscle fibers. DISCUSSION DR. A. M. JUDD.-1
have seen but two cases of inversion of the uterus. One was acute and the patient died within a few minutes after I reduced it. The other existed for nine m.onths after its occurrence. The patient was extremely anemic The patient recovered and subsequently and in that ease I did a Spinelli operation. had a baby after that normally.
DR. ELIOT BISHOP.-1 have seen only one case of inversion of the uterus, five or six hours after delivery and in some shock. The patient was referred to the hospital after delivery at home. At that t.irne the Spinelli was the operation of choice, unless the uterus could be kasily resposited, and not being able to reduce the uterus in that case 1 attacked it by the Spinelli method, and the patient died on the operating table. A newer and better method of attack is described by Huntington, Kellogg and Irving, of Boston, in an articlc published by them in the AMERICAN JOURNAL OF OBSTETRLCSAND GYNECOLOGY 15: 34; 1928. Their practice is to immediately transfuse the patient to combat shock, the major problem, and do a quick laparotomy; the inversion is reduced in tho reverse order of occurrence, using Allis clamps. This is much more simple than the complicat)cd Spinelli procedure, which also invades the peritoneal cavity, though from below. DR.
EDWIN W. HOLLADAY described the Repair of an Intrac@ble VeaicoFistula. The successful, complete cure of this case was felt to be due to several minor points in technic and for that reason it is presented.
vaginal
The patient, Mrs. M. P., Greek, thirty-one years of age, para v, was about five Her family history and previous medical feet tall and weighed 155 pounds. history had no bearing on the present condition. Her present complaint began five years ago following the birth of her fourth During this time she child, since which time she has had incontinence of urine. has undergone five unsuccessful operations by different operators in other cities. Three of these operations were vaginal, one was suprapubic, and one was an attempt at vaginal followed by a suprapubic operation. Following the first operation a diagnosis of bilateral renal tuberculosis was made from cystoscopic examination. In addition, following the third operation a cesarean section was done, most likely because of the fistula and the extensive scar tissue present. She had thus undergone six operations in less than four years. She was admitted to Bellevue 262
YORK MEETING
Transactions
OBSTETRICAL OF
MARCH
SOCIETY 11,
1930
D IR. J. H. TELFAIR presented a report on Complete Inversion of the Uterus During Labor, and said that this was the second case where he reinverted the uterus by simply pushing it up into the pelvis, and in each case it was rather easy to replace the uterus in normal position through the noncontracted cervical muscle fibers. DISCUSSION DR. A. M. JUDD.-1
have seen but two cases of inversion of the uterus. One was acute and the patient died within a few minutes after I reduced it. The other existed for nine m.onths after its occurrence. The patient was extremely anemic The patient recovered and subsequently and in that ease I did a Spinelli operation. had a baby after that normally.
DR. ELIOT BISHOP.-1 have seen only one case of inversion of the uterus, five or six hours after delivery and in some shock. The patient was referred to the hospital after delivery at home. At that t.irne the Spinelli was the operation of choice, unless the uterus could be kasily resposited, and not being able to reduce the uterus in that case 1 attacked it by the Spinelli method, and the patient died on the operating table. A newer and better method of attack is described by Huntington, Kellogg and Irving, of Boston, in an articlc published by them in the AMERICAN JOURNAL OF OBSTETRLCSAND GYNECOLOGY 15: 34; 1928. Their practice is to immediately transfuse the patient to combat shock, the major problem, and do a quick laparotomy; the inversion is reduced in tho reverse order of occurrence, using Allis clamps. This is much more simple than the complicat)cd Spinelli procedure, which also invades the peritoneal cavity, though from below. DR.
EDWIN W. HOLLADAY described the Repair of an Intrac@ble VeaicoFistula. The successful, complete cure of this case was felt to be due to several minor points in technic and for that reason it is presented.
vaginal
The patient, Mrs. M. P., Greek, thirty-one years of age, para v, was about five Her family history and previous medical feet tall and weighed 155 pounds. history had no bearing on the present condition. Her present complaint began five years ago following the birth of her fourth During this time she child, since which time she has had incontinence of urine. has undergone five unsuccessful operations by different operators in other cities. Three of these operations were vaginal, one was suprapubic, and one was an attempt at vaginal followed by a suprapubic operation. Following the first operation a diagnosis of bilateral renal tuberculosis was made from cystoscopic examination. In addition, following the third operation a cesarean section was done, most likely because of the fistula and the extensive scar tissue present. She had thus undergone six operations in less than four years. She was admitted to Bellevue 262